Bilateral avascular necrosis leading to hip fracture in pregnancy: A case report

Abstract

Avascular necrosis (AVN) of the hip, a rare cause of pelvic pain in the third trimester of pregnancy, often presents with nonspecific symptoms that resemble common musculoskeletal conditions. This ambiguity, coupled with concerns about the safety of magnetic resonance imaging (MRI) during pregnancy, can hinder timely diagnosis. We report a unique case of a 32-year-old primigravida diagnosed with a hip fracture and bilateral AVN of the femoral head in the immediate postpartum period, a complication seemingly not previously documented in pregnant patients. The initial management involved closed reduction and internal fixation using cannulated screws. However, progressive femoral head collapse necessitated revision to a total hip arthroplasty. This case underscores the importance of early diagnosis and recognition of AVN in pregnancy to prevent severe complications. It highlights the diagnostic challenges and emphasizes the need for heightened awareness and earlier imaging investigations in similar clinical scenarios.

Keywords

• Avascular necrosis
• Hip
• Pregnancy
• Internal fixation
• Hip replacement